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Transcript of Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical...
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Pain, Mood, & Meditation-
Where does Spirituality fit?
Amy Wachholtz, PhD, MDiv
UMass Medical SchoolPsychiatry Day, 2009
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Outline
1. Bio-psycho-social-spiritual model of pain
2. What are the mechanisms linking meditationand pain?
3. Who uses Prayer/Meditation to cope with pain?
4. When do people use Prayer/Meditation for pain?
5. What does spirituality add to meditation for paincoping?
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Question #1 What is Pain?
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Typical Pain Cycle
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Gate/Neuromatrix Theory of Pain
Injury Signals
Gate
ThoughtsEmotions
Behaviors
Ouch!
I feel good!
Melzack & Wall, 1965
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Influences on Chronic Pain
Chronic
Pain
BiologicalFactors
Psychological
Factors
Social
Factors
SpiritualFactors
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Question #2: What arethe mechanisms linkingmeditation and pain?
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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What role does meditation play?
Secular meditation & pain MBSR (Kabat-Zinn)
Relaxation response (Benson)
Spiritual meditation & pain TM
Yoga Loving-Kindness
Beyond the Relaxation Response
Religious Tradition based meditation
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Meditation Pathways and Pain
Meditation
Positive Mood
Internalized Locus of Control
Self-Efficacy
Anxiety
Distraction from Problems
Decreased Focus on the Body
Reduced Pain FrequencyIncreased Pain ToleranceDecreased Pain Sensitivity
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Altered Perceptions
Changed Mood
Changed Social Interactions
Changed Behaviors
Physiological/Neurological Changes
Altered neurotransmitter levels
Altered sleep
Altered HPA activity levelsAltered threshold for recognizing distress signals
Psycho-Social Changes
Meaning Making Attributions
Self-Efficacy
Distraction
Social Support
Instrumental Support
Relaxation
Possible Unique R/S Factor
Spiritual Support
Spiritual Growth
Spiritual Meaning Making AttributionsAdditional Efficacy Beliefs
Spiritual Beliefs and Practices
Positive vs. Negative
Public vs. Private
Intrinsic vs. Extrinsic
Existential vs. Religious
(Adapted from:
Wachholtz, Pearce
& Koenig, 2007)
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Common R/S Coping Tools
1. Prayer2. Spiritual Meditation3. Hope4. Reading faith-based literature5. Finding spiritual role models for coping6. Seeking spiritual support/connection7. Church attendance8. Seeking instrumental support9. Religious reappraisal
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Question #3: Who usesprayer/meditation to cope
with pain?
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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National Health Interview Survey 2002-2007(Wachholtz & Sambamthoori, 2009)
Older (>33 years)
Female
More Educated (> High School)
African-American (vs. white) Have chronic mental or physical health issues:
depression, chronic headaches, back and/or
neck pain
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Question #4: When dopeople use prayer/meditation
to cope with pain?
Pain
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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The initial spiritual pain coping response to acute pain(self-directive), is the least likely spiritual copingresponse to chronic pain (collaborative) (Dunn & Horgas, 2004)
Terminal stage illnesses with co-morbid pain (Yates, et al., 1981;Ironson, et al, 2002)
Long-term chronic pain (Abraido-Lanza, et al., 2004; Glover-Graf, et al., 2007)
Uncontrollable, intermittent pain (Harrison, et al., 2005)
When other coping mechanisms fail and spiritualcoping is efficacious (Keefe, et al., 2001; Pargament, 2002)
Religious/spiritual coping AND secular coping- not
either/or
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Question #5: What doesspirituality add to meditation?
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Intervention Studies
Spiritual interventions affect physiologicaloutcomes (Carlson, Bacaseta, and Simanton, 1988; Ironson, et al., 2002,Pargament et al., 2005; Wenneberg, et al., 1997 )
Increase pain tolerance in healthy, non-chronicpain individuals (Wachholtz & Pargament, 2005)
Doubled pain tolerance to laboratory induced acutepain task
Meditation inherently spiritual?
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Improved pain tolerance among a chronicpain group (Wachholtz & Pargament, 2008)4 weeksDecreased pain frequencyGreater pain tolerance
Acute- laboratory induced painChronic- decreased rescue medication usage
Limited change in pain sensitivityGreater decrease in negative moodGreater decrease in anxiety
Intervention Studies
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Buddhist Loving-Kindness
Cancer patients(Carson, et al, 2008)
Migraineurs Pilot Study(Wachholtz, 2009)4 week class, 4 week follow up
Increased spiritual experiences
Elevated pain tolerance
Fewer headaches (n.s.)
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7/29/2019 Pain, Mood, & Meditation- Where does Spirituality fit?- By: Amy Wachholtz, PhD, MDiv UMass Medical School Psychiatry Day, 2009
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Summary
Pain a multi-dimensional disorder including physiological,psychological, social and spiritual components
Prayer and spiritual meditation used by many with chronic
pain
Multiple psychological and physiological pathways thatsupport its use
Spiritual meditation may be a useful resource with uniqueadditive components for patients with a spiritual/religiousbackground
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